A community-based program integrating assertive outreach, medications for opioid use disorder, behavioral counseling, peer recovery support, and paramedic follow-up
To increase accessibility to evidence-based care, Houston Emergency Opioid Engagement System (HEROES) is a program based at the University of Texas Health Science Center of Houston in collaboration with multiple community organizations including the Houston Fire Department, Houston Police Department, Houston Recovery Center, and Memorial Hermann Hospital as well as other public health and social service providers.
A quick response team, comprised of a paramedic paired with a peer recovery coach, use a data-driven outreach response. Information is used from emergency medical services (EMS) about individuals who have been revived with a naloxone intervention. In addition to post-overdose response in the emergency department (ED), the team provides active outreach to connect with these individuals, using motivational interviewing to establish rapport and to help individuals make a positive decision to start treatment and enter recovery. Same-day induction with buprenorphine in the ED is followed by the HEROES program linking the individual to more permanent, outpatient treatment with community providers.
Overall aims of HEROES include:
- provide comprehensive treatment for those with opioid use disorders
- gain a more thorough understanding of the opioid crisis in Houston
- develop a coordinated system of care
- ultimately, to save lives
The program has been described in the peer-review literature along with preliminary results. The program has also been evaluated specifically based on its referrals from the criminal justice system. More information can be found in this news article.
HEROES is primarily funded by the Texas Targeted Opioid Response program, which is funded by SAMHSA.
The program adapted to COVID-19 by rapidly enacting virtual care with telehealth for peer coaching, counseling, groups, and provider visits and reported an overall increase in patient engagement over time.